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dc.contributor.author | Ngandu, Nobubelo Kwanele![]() |
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dc.contributor.author | Jackson, Debra![]() |
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dc.contributor.author | Lombard, Carl![]() |
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dc.contributor.author | Nsibande, Duduzile Faith![]() |
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dc.contributor.author | Dinh, Thu-Ha![]() |
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dc.contributor.author | Magasana, Vuyolwethu![]() |
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dc.contributor.author | Mogashoa, Mary![]() |
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dc.contributor.author | Goga, Ameena Ebrahim![]() |
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dc.date.accessioned | 2020-07-10T13:27:49Z | |
dc.date.available | 2020-07-10T13:27:49Z | |
dc.date.issued | 2019-09-16 | |
dc.description | Additional file 1: Baseline characteristics at 6 weeks postpartum presented by patterns of MV per time-point. MV- non-attendance at scheduled postnatal care visits. Proportions of participants who missed each follow-up visit point when they were eligible to attend it. The proportions are presented per sub-group of each baseline characteristic measured at 6 weeks postpatrum, i.e., row percentages are given. Significant chi-squared ps for differences in proportions of MV between sub-groups of each baseline characteristic, per visit point, are presented in bold face. All proportions were adjusted for survey sampling weights (W %). South African provinces- WC-Western Cape, NW-North West, NC-Northen Cape, MP-Mpumalanga, LP-Limpopo, KZN-KwaZulu Natal, GP-Gauteng, FS-Free State, EC-Eastern Cape. | en_ZA |
dc.description | Additional file 2: Actual number of missed visits (MV-frequency) presented according to the number of scheduled (exposed) visits. The number and percentage of participants who missed a specific number of visits out of the total number of scheduled visits they were expected to attend (exposed visits). The description of ‘exposed visits’ is given in Methods under ‘Describing patterns of ‘missed visits” sub-heading. For example, a total of 23 participants were expected to have attended only 3 visits (3 was their total number of exposed visits), 7 of these attended all the three visits (MV-frequency = 0) and 16 missed 1 visit. | en_ZA |
dc.description.abstract | BACKGROUND : Since 2001 the South African guidelines to improve child health and prevent vertical HIV transmission recommended frequent infant follow-up with HIV testing at 18 months postpartum. We sought to understand non-attendance at scheduled follow-up study visits up to 18 months, and for the 18-month infant HIV test amongst a nationally representative sample of HIV exposed uninfected (HEU) infants from a high HIV-prevalence African setting. METHODS : Secondary analysis of data drawn from a nationally representative observational cohort study (conducted during October 2012 to September 2014) of HEU infants and their primary caregivers was undertaken. Participants were eligible (N = 2650) if they were 4–8 weeks old and HEU at enrolment. All enrolled infants were followed up every 3months up to 18months. Each follow-up visit was scheduled to coincide with each child’s routine health visit, where possible. The denominator at each time point comprised HEU infants who were alive and HIV-free at the previous visit. We assessed baseline maternal and early HIV care characteristics associated with the frequency of ‘Missed visits’ (MV-frequency), using a negative binomial regression model adjusting for the follow-up time in the study, and associated with missed visits at 18 months (18-month MV) using a logistic regression model. RESULTS : The proportion of eligible infants with MV was lowest at 3 months (32.7%) and 18 months (31.0%) and highest at 12 months (37.6%). HIV-positive mothers not on triple antiretroviral therapy (ART) by 6-weeks postpartum had a significantly increased occurrence rate of ‘MV-frequency’ (adjusted incidence rate ratio, 1.2 (95% confidence interval (CI), 1.1–1.4), p < 0.0001). Compared to those mothers with ART, these mothers also increased the risk of ‘18-month-MV’ (adjusted odds ratio, 1.3 (CI, 1.1–1.6), p = 0.006). Unknown infant nevirapine-intake status increased the rate of ‘MV-frequency’ (p = 0.02). Mothers > 24 years had a significantly reduced rate of ‘MV-frequency’ (p ≤ 0.01) and risk of ‘18-month-MV’ (p < 0.01) compared to younger women. Shorter travel time to health facility lowered the occurrence of ‘MV-frequency’ (p ≤ 0.004). CONCLUSION : Late initiation of maternal ART and infant prophylaxis under the Option- A policy and extended travel time to clinics (measured at 6 weeks postpartum), contributed to higher postnatal MV rates. Mothers older than 24 years had lower MV rates. Targeted interventions may be needed during the current PMTCT Option B+ (lifelong ART to pregnant and lactating women at HIV diagnosis) to circumvent these risk factors and reduce missed visits during HIV-care. | en_ZA |
dc.description.department | Paediatrics and Child Health | en_ZA |
dc.description.librarian | am2020 | en_ZA |
dc.description.sponsorship | The President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention (CDC) under the terms of the Cooperative Agreement between CDC and MRC (1U2GPS001137–02 and 1U2GPS001137–03), the United Nations Children’s Fund (UNICEF), National Department of Health, South Africa, South Africa National Research Foundation and the South African Medical Research Council (SAMRC). | en_ZA |
dc.description.uri | https://bmcinfectdis.biomedcentral.com | en_ZA |
dc.identifier.citation | Ngandu, N.K., Jackson, D., Lombard, C. et al. 2019, 'Factors associated with non-attendance at scheduled infant follow-up visits in an observational cohort of HIV-exposed infants in South Africa, 2012–2014', BMC Infectious Diseases, vol. 19, art. 788, suppl. 1, pp. 1-11. | en_ZA |
dc.identifier.issn | 1471-2334 (online) | |
dc.identifier.other | 10.1186/s12879-019-4340-5 | |
dc.identifier.uri | http://hdl.handle.net/2263/75130 | |
dc.language.iso | en | en_ZA |
dc.publisher | BioMed Central | en_ZA |
dc.rights | © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License. | en_ZA |
dc.subject | HIV-exposed infants | en_ZA |
dc.subject | Postnatal care | en_ZA |
dc.subject | Missed visits | en_ZA |
dc.subject | Human immunodeficiency virus (HIV) | en_ZA |
dc.subject | South Africa (SA) | en_ZA |
dc.subject | HIV exposed uninfected (HEU) | en_ZA |
dc.subject | Infants | en_ZA |
dc.subject | Antiretroviral therapy (ART) | en_ZA |
dc.title | Factors associated with non-attendance at scheduled infant follow-up visits in an observational cohort of HIV-exposed infants in South Africa, 2012–2014 | en_ZA |
dc.type | Article | en_ZA |